Loperfido Antonella, Cavaliere Carlo, Ciofalo Andrea, Bugani Marcella, Begvarfaj Elona, Millarelli Stefano, Bellocchi Gianluca, de Vincentiis Marco, Masieri Simonetta
Otolaryngology Unit, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, Rome, 00152, Italy.
Department of Sense Organs, Sapienza University, Rome, 00185, Italy.
Eur Arch Otorhinolaryngol. 2025 Sep;282(9):4681-4690. doi: 10.1007/s00405-025-09619-y. Epub 2025 Aug 4.
PURPOSE: Biologics targeting the underlying inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) not only alleviate symptoms but also provide potential disease-modifying effects. This has redefined treatment goals in CRSwNP, emphasizing the concept of achieving disease remission as proposed by the EPOS2020/EUFOREA expert panel. Remission in CRSwNP is defined as sustained control for at least 12 months, along with the absence of active disease as assessed by nasal endoscopy. The purpose of this study was to identify patients with severe CRSwNP who achieved disease remission during the first two years of Dupilumab treatment. METHODS: This real-life, observational, retrospective study evaluated the effectiveness and safety of Dupilumab in patients with severe, uncontrolled CRSwNP over two years. Remission was assessed taking into account the latest EPOS2020/EUFOREA expert panel and currently available expert opinion on the topic. Data were collected at baseline and after 1, 3, 6, 9, 12, 18, and 24 months, focusing on nasal polyp score (NPS), symptoms, olfactory function, and quality of life (QoL). Additionally, the safety profile was evaluated by monitoring side effects and eosinophil blood count. RESULTS: A total of 30 patients (19 males, 11 females; mean age 53.7 years) were included. Dupilumab treatment led to significant clinical improvements, including a reduction in NPS, relief of nasal symptoms, and notable improvements in olfactory function and QoL, as demonstrated through SNOT-22 and VAS scores. Twenty-three patients (77%) achieved disease remission. CONCLUSION: This retrospective study confirms the efficacy of Dupilumab in managing difficult-to-treat, type-2 inflammation-driven CRSwNP, with a high percentage of patients achieving remission. Further studies with larger cohorts along with universal guidelines establishing validated criteria, including specific cut-off values, for a standardized definition of remission in CRSwNP are required.
目的:针对伴有鼻息肉的慢性鼻-鼻窦炎(CRSwNP)潜在炎症的生物制剂不仅能缓解症状,还具有潜在的疾病改善作用。这重新定义了CRSwNP的治疗目标,强调了实现如EPOS2020/EUFOREA专家小组所提出的疾病缓解的概念。CRSwNP中的缓解定义为持续控制至少12个月,且经鼻内镜检查评估无活动性疾病。本研究的目的是识别在度普利尤单抗治疗的头两年实现疾病缓解的重度CRSwNP患者。 方法:这项真实世界、观察性、回顾性研究评估了度普利尤单抗在两年内对重度、未得到控制的CRSwNP患者的有效性和安全性。根据最新的EPOS2020/EUFOREA专家小组意见以及目前关于该主题的专家意见对缓解情况进行评估。在基线以及1、3、6、9、12、18和24个月后收集数据,重点关注鼻息肉评分(NPS)、症状、嗅觉功能和生活质量(QoL)。此外,通过监测副作用和嗜酸性粒细胞计数来评估安全性。 结果:共纳入30例患者(19例男性,11例女性;平均年龄53.7岁)。度普利尤单抗治疗带来了显著的临床改善,包括NPS降低、鼻部症状缓解以及嗅觉功能和QoL的显著改善,这通过SNOT-22和VAS评分得以证明。23例患者(77%)实现了疾病缓解。 结论:这项回顾性研究证实了度普利尤单抗在治疗难治性、2型炎症驱动的CRSwNP方面的疗效,有很高比例的患者实现缓解。需要开展更大队列的进一步研究,并制定通用指南,确立用于CRSwNP缓解标准化定义的经过验证的标准,包括特定的临界值。
Eur Arch Otorhinolaryngol. 2025-9
Braz J Otorhinolaryngol. 2025-4-25
Eur Arch Otorhinolaryngol. 2025-2
J Allergy Clin Immunol. 2025-2
Eur Arch Otorhinolaryngol. 2025-7-12
Cochrane Database Syst Rev. 2016-4-26
Rheumatology (Oxford). 2025-5-1
Rhinology. 2025-4-1
Curr Allergy Asthma Rep. 2025-2-5
J Allergy Clin Immunol. 2025-2
J Allergy Clin Immunol Pract. 2025-1
Eur Arch Otorhinolaryngol. 2024-12